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Open Access 01-12-2016 | Protocol

Assessment of clinically related outcomes and biomarker analysis for translational integration in colorectal cancer (ACROBATICC): study protocol for a population-based, consecutive cohort of surgically treated colorectal cancers and resected colorectal liver metastasis

Authors: Kjetil Søreide, Martin M. Watson, Dordi Lea, Oddmund Nordgård, Jon Arne Søreide, Hanne R. Hagland, ACROBATICC collaborators

Published in: Journal of Translational Medicine | Issue 1/2016

Abstract

Background

More accurate predictive and prognostic biomarkers for patients with colorectal cancer (CRC) primaries or colorectal liver metastasis (CLM) are needed. Outside clinical trials, the translational integration of emerging pathways and novel techniques should facilitate exploration of biomarkers for improved staging and prognosis.

Methods

An observational study exploring predictive and prognostic biomarkers in a population-based, consecutive cohort of surgically treated colorectal cancers and resected colorectal liver metastases. Long-term outcomes will be cancer-specific survival, recurrence-free survival and overall survival at 5 years from diagnosis. Beyond routine clinicopathological and anthropometric characteristics and laboratory and biochemistry results, the project allows for additional blood samples and fresh-frozen tumour and normal tissue for investigation of circulating tumour cells (CTCs) and novel biomarkers (e.g. immune cells, microRNAs etc.). Tumour specimens will be investigated by immunohistochemistry in full slides. Extracted DNA/RNA will be analysed for genomic markers using specific PCR techniques and next-generation sequencing (NGS) panels. Flow cytometry will be used to characterise biomarkers in blood. Collaboration is open and welcomed, with particular interest in mutual opportunities for validation studies.

Status and perspectives

The project is ongoing and recruiting at an expected rate of 120–150 patients per year, since January 2013. A project on circulating tumour cells (CTCs) has commenced, with analysis being prepared. Investigating molecular classes beyond the TNM staging is under way, including characteristics of microsatellite instability (MSI) and elevated microsatellite alterations in selected tetranucleotides (EMAST). Hot spot panels for known mutations in CRC are being investigated using NGS. Immune-cell characteristics are being performed by IHC and flow cytometry in tumour and peripheral blood samples. The project has ethical approval (REK Helse Vest, #2012/742), is financially supported with a Ph.D.-Grant (EMAST project; Folke Hermansen Cancer Fund) and a CTC-project (Norwegian Research Council; O. Nordgård). The ACROBATICC clinical and molecular biobank repository will serve as a long-term source for novel exploratory analysis and invite collaborators for mutual validation of promising biomarker results. The project aims to generate results that can help better discern prognostic groups in stage II/III cancers; explore prognostic and predictive biomarkers, and help detail the biology of colorectal liver metastasis for better patient selection and tailored treatment. The project is registered at http://www.ClinicalTrials.gov NCT01762813.

Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2016. doi:10.1136/gutjnl-2015-310912.

Nedrebo BS, Soreide K, Eriksen MT, Dorum LM, Kvaloy JT, Soreide JA, et al. Survival effect of implementing national treatment strategies for curatively resected colonic and rectal cancer. Br J Surg. 2011;98(5):716–23. doi:10.1002/bjs.7426.CrossRefPubMed

Veen T, Nedrebo BS, Stormark K, Soreide JA, Korner H, Soreide K. Qualitative and quantitative issues of lymph nodes as prognostic factor in colon cancer. Dig Surg. 2013;30(1):1–11. doi:10.1159/000349923.CrossRefPubMed

Lea D, Haland S, Hagland HR, Soreide K. Accuracy of TNM staging in colorectal cancer: a review of current culprits, the modern role of morphology and stepping-stones for improvements in the molecular era. Scand J Gastroenterol. 2014;49(10):1153–63. doi:10.3109/00365521.2014.950692.CrossRefPubMed

Soreide K, Nedrebo BS, Soreide JA, Slewa A, Korner H. Lymph node harvest in colon cancer: influence of microsatellite instability and proximal tumor location. World J Surg. 2009;33(12):2695–703. doi:10.1007/s00268-009-0255-4.CrossRefPubMed

Berg M, Guriby M, Nordgard O, Nedrebo BS, Ahlquist TC, Smaaland R, et al. Influence of microsatellite instability and KRAS and BRAF mutations on lymph node harvest in stage I-III colon cancers. Mol Med. 2013;19:286–93. doi:10.2119/molmed.2013.00049.CrossRefPubMedPubMedCentral

Oltedal S, Gilje B, Korner H, Aasprong OG, Tjensvoll K, Heikkila R, et al. Detection of occult metastases in sentinel lymph nodes from colon cancer patients by K-ras mutation peptide nucleic acid clamp PCR. Ann Surg. 2010;251(6):1087–91. doi:10.1097/SLA.0b013e3181dae1bc.CrossRefPubMed

Nordgard O, Oltedal S, Aasprong OG, Soreide JA, Soreide K, Tjensvoll K, et al. Prognostic relevance of occult metastases detected by cytokeratin 20 and mucin 2 mRNA levels in sentinel lymph nodes from colon cancer patients. Ann Surg Oncol. 2012;19(12):3719–26. doi:10.1245/s10434-012-2454-8.CrossRefPubMed

Seeberg LT, Waage A, Brunborg C, Hugenschmidt H, Renolen A, Stav I, et al. Circulating tumor cells in patients with colorectal liver metastasis predict impaired survival. Ann Surg. 2015;261(1):164–71. doi:10.1097/sla.0000000000000580.CrossRefPubMed

10.

Huang X, Gao P, Song Y, Sun J, Chen X, Zhao J, et al. Relationship between circulating tumor cells and tumor response in colorectal cancer patients treated with chemotherapy: a meta-analysis. BMC Cancer. 2014;14:976. doi:10.1186/1471-2407-14-976.CrossRefPubMedPubMedCentral

11.

Huang X, Gao P, Song Y, Sun J, Chen X, Zhao J, et al. Meta-analysis of the prognostic value of circulating tumor cells detected with the cell search system in colorectal cancer. BMC Cancer. 2015;15:202. doi:10.1186/s12885-015-1218-9.CrossRefPubMedPubMedCentral

12.

Iinuma H, Watanabe T, Mimori K, Adachi M, Hayashi N, Tamura J, et al. Clinical significance of circulating tumor cells, including cancer stem-like cells, in peripheral blood for recurrence and prognosis in patients with Dukes’ stage B and C colorectal cancer. J Clin Oncol. 2011;29(12):1547–55. doi:10.1200/jco.2010.30.5151.CrossRefPubMed

13.

Soreide K, Janssen EA, Soiland H, Korner H, Baak JP. Microsatellite instability in colorectal cancer. Br J Surg. 2006;93(4):395–406. doi:10.1002/bjs.5328.CrossRefPubMed

14.

Berg M, Hagland HR, Soreide K. Comparison of CpG island methylator phenotype (CIMP) frequency in colon cancer using different probe- and gene-specific scoring alternatives on recommended multi-gene panels. PLoS One. 2014;9(1):e86657. doi:10.1371/journal.pone.0086657.CrossRefPubMedPubMedCentral

15.

Berg M, Nordgaard O, Korner H, Oltedal S, Smaaland R, Soreide JA, et al. Molecular subtypes in stage II-III colon cancer defined by genomic instability: early recurrence-risk associated with a high copy-number variation and loss of RUNX3 and CDKN2A. PLoS One. 2015;10(4):e0122391. doi:10.1371/journal.pone.0122391.CrossRefPubMedPubMedCentral

16.

Soreide K, Soreide JA, Korner H. Prognostic role of carcinoembryonic antigen is influenced by microsatellite instability genotype and stage in locally advanced colorectal cancers. World J Surg. 2011;35(4):888–94. doi:10.1007/s00268-011-0979-9.CrossRefPubMed

17.

Soreide K, Slewa A, Stokkeland PJ, van Diermen B, Janssen EA, Soreide JA, et al. Microsatellite instability and DNA ploidy in colorectal cancer: potential implications for patients undergoing systematic surveillance after resection. Cancer. 2009;115(2):271–82. doi:10.1002/cncr.24024.CrossRefPubMed

18.

Linnekamp JF, Wang X, Medema JP, Vermeulen L. Colorectal cancer heterogeneity and targeted therapy: a case for molecular disease subtypes. Cancer Res. 2015;75(2):245–9. doi:10.1158/0008-5472.can-14-2240.CrossRefPubMed

19.

Guinney J, Dienstmann R, Wang X, de Reynies A, Schlicker A, Soneson C, et al. The consensus molecular subtypes of colorectal cancer. Nat Med. 2015;21(11):1350–6. doi:10.1038/nm.3967.CrossRefPubMedPubMedCentral

20.

Betge J, Kerr G, Miersch T, Leible S, Erdmann G, Galata CL, et al. Amplicon sequencing of colorectal cancer: variant calling in frozen and formalin-fixed samples. PLoS One. 2015;10(5):e0127146. doi:10.1371/journal.pone.0127146.CrossRefPubMedPubMedCentral

21.

McShane LM, Hayes DF. Publication of tumor marker research results: the necessity for complete and transparent reporting. J Clin Oncol. 2012;30(34):4223–32. doi:10.1200/jco.2012.42.6858.CrossRefPubMedPubMedCentral

22.

Simeon-Dubach D, Burt AD, Hall PA. Quality really matters: the need to improve specimen quality in biomedical research. J Pathol. 2012;228(4):431–3. doi:10.1002/path.4117.CrossRefPubMed

23.

Carethers JM, Jung BH. Genetics and genetic biomarkers in sporadic colorectal cancer. Gastroenterology. 2015;149(5):1177–1190.e3. doi:10.1053/j.gastro.2015.06.047.CrossRefPubMed

24.

Okugawa Y, Grady WM, Goel A. Epigenetic alterations in colorectal cancer: emerging biomarkers. Gastroenterology. 2015;149(5):1204–1225.e12. doi:10.1053/j.gastro.2015.07.011.CrossRefPubMed

25.

Watson MM, Berg M, Soreide K. Prevalence and implications of elevated microsatellite alterations at selected tetranucleotides in cancer. Br J Cancer. 2014;111(5):823–7. doi:10.1038/bjc.2014.167.CrossRefPubMedPubMedCentral

26.

Koi M, Garcia M, Choi C, Kim HR, Koike J, Hemmi H, et al. Microsatellite alterations with allelic loss at 9p24.2 signify less-aggressive colorectal cancer metastasis. Gastroenterology. 2016. doi:10.1053/j.gastro.2015.12.032.PubMed

27.

Watson MM, Lea D, Rewcastle E, Hagland HR, Søreide K. Elevated microsatellite alterations at selected tetranucleotides in early-stage colorectal cancers with and without high-frequency microsatellite instability: same, same but different? Cancer medicine. 2016. doi:10.1002/cam4.709.PubMedCentral

28.

Søreide K, Watson MM, Hagland HR. Deciphering the molecular code to colorectal liver metastasis biology through microsatellite alterations and allelic loss: the good, the bad, and the ugly. Gastroenterology. 2016;150(4):811–4. doi:10.1053/j.gastro.2016.02.060.CrossRefPubMed

29.

Soreide K, Sandvik OM, Soreide JA. KRAS mutation in patients undergoing hepatic resection for colorectal liver metastasis: a biomarker of cancer biology or a byproduct of patient selection? Cancer. 2014;120(24):3862–5. doi:10.1002/cncr.28979.CrossRefPubMedPubMedCentral

30.

Berg M, Soreide K. EGFR and downstream genetic alterations in KRAS/BRAF and PI3K/AKT pathways in colorectal cancer: implications for targeted therapy. Discov Med. 2012;14(76):207–14.PubMed

31.

Maby P, Tougeron D, Hamieh M, Mlecnik B, Kora H, Bindea G, et al. Correlation between density of CD8+ T-cell infiltrate in microsatellite unstable colorectal cancers and frameshift mutations: a rationale for personalized immunotherapy. Cancer Res. 2015;75(17):3446–55. doi:10.1158/0008-5472.can-14-3051.CrossRefPubMed

32.

Steinert G, Scholch S, Niemietz T, Iwata N, Garcia SA, Behrens B, et al. Immune escape and survival mechanisms in circulating tumor cells of colorectal cancer. Cancer Res. 2014;74(6):1694–704. doi:10.1158/0008-5472.can-13-1885.CrossRefPubMed

33.

Pentheroudakis G, Raptou G, Kotoula V, Wirtz RM, Vrettou E, Karavasilis V, et al. Immune response gene expression in colorectal cancer carries distinct prognostic implications according to tissue, stage and site: a prospective retrospective translational study in the context of a hellenic cooperative oncology group randomised trial. PLoS One. 2015;10(5):e0124612. doi:10.1371/journal.pone.0124612.CrossRefPubMedPubMedCentral

34.

Sandvik OM, Soreide K, Gudlaugsson E, Kvaloy JT, Soreide JA. Epidemiology and classification of gastroenteropancreatic neuroendocrine neoplasms using current coding criteria. Br J Surg. 2016;103(3):226–32. doi:10.1002/bjs.10034.CrossRefPubMed

35.

Sandvik OM, Soreide K, Kvaloy JT, Gudlaugsson E, Soreide JA. Epidemiology of gastrointestinal stromal tumours: single-institution experience and clinical presentation over three decades. Cancer Epidemiol. 2011;35(6):515–20. doi:10.1016/j.canep.2011.03.002.CrossRefPubMed

36.

Meling T, Harboe K, Soreide K. Incidence of traumatic long-bone fractures requiring in-hospital management: a prospective age- and gender-specific analysis of 4890 fractures. Injury. 2009;40(11):1212–9. doi:10.1016/j.injury.2009.06.003.CrossRefPubMed

37.

Reite A, Soreide K, Ellingsen CL, Kvaloy JT, Vetrhus M. Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality. J Vasc Surg. 2015;61(5):1168–74. doi:10.1016/j.jvs.2014.12.054.CrossRefPubMed

38.

Thorsen K, Soreide JA, Kvaloy JT, Glomsaker T, Soreide K. Epidemiology of perforated peptic ulcer: age- and gender-adjusted analysis of incidence and mortality. World J Gastroenterol. 2013;19(3):347–54. doi:10.3748/wjg.v19.i3.347.CrossRefPubMedPubMedCentral

39.

Soreide K, Kruger AJ, Vardal AL, Ellingsen CL, Soreide E, Lossius HM. Epidemiology and contemporary patterns of trauma deaths: changing place, similar pace, older face. World J Surg. 2007;31(11):2092–103. doi:10.1007/s00268-007-9226-9.CrossRefPubMed

40.

Veen T, Stormark K, Nedrebo BS, Berg M, Soreide JA, Korner H, et al. Long-term follow-up and survivorship after completing systematic surveillance in stage I–III colorectal cancer: who is still at risk? J Gastrointest Cancer. 2015;46(3):259–66. doi:10.1007/s12029-015-9723-2.CrossRefPubMedPubMedCentral

41.

Korner H, Soreide K, Stokkeland PJ, Soreide JA. Systematic follow-up after curative surgery for colorectal cancer in Norway: a population-based audit of effectiveness, costs, and compliance. J Gastrointest Surg. 2005;9(3):320–8. doi:10.1016/j.gassur.2004.09.023.CrossRefPubMed

42.

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9. doi:10.1016/j.jclinepi.2007.11.008.CrossRef

43.

Stormark K, Søreide K, Søreide JA, Kvaløy JT, Pfeffer F, Eriksen MT, et al. Nationwide implementation of laparoscopic surgery for colon cancer: short-term outcomes and long-term survival in a population-based cohort. Surg Endosc. 2016. doi:10.1007/s00464-016-4819-8.PubMed

44.

Moore HM, Kelly AB, Jewell SD, McShane LM, Clark DP, Greenspan R, et al. Biospecimen reporting for improved study quality (BRISQ). J Proteome Res. 2011;10(8):3429–38. doi:10.1021/pr200021n.CrossRefPubMedPubMedCentral

45.

McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM. REporting recommendations for tumour MARKer prognostic studies (REMARK). Br J Cancer. 2005;93(4):387–91. doi:10.1038/sj.bjc.6602678.CrossRefPubMedPubMedCentral

46.

Koren R, Kyzer S, Paz A, Veltman V, Klein B, Gal R. Lymph node revealing solution: a new method for detection of minute axillary lymph nodes in breast cancer specimens. Am J Surg Pathol. 1997;21(11):1387–90.CrossRefPubMed

47.

Bao WG, Zhang X, Zhang JG, Zhou WJ, Bi TN, Wang JC, et al. Biobanking of fresh-frozen human colon tissues: impact of tissue ex vivo ischemia times and storage periods on RNA quality. Ann Surg Oncol. 2013;20(5):1737–44. doi:10.1245/s10434-012-2440-1.CrossRefPubMed

48.

Bray SE, Paulin FE, Fong SC, Baker L, Carey FA, Levison DA, et al. Gene expression in colorectal neoplasia: modifications induced by tissue ischaemic time and tissue handling protocol. Histopathology. 2010;56(2):240–50. doi:10.1111/j.1365-2559.2009.03470.x.CrossRefPubMed

49.

Alix-Panabieres C, Pantel K. Challenges in circulating tumour cell research. Nat Rev Cancer. 2014;14(9):623–31. doi:10.1038/nrc3820.CrossRefPubMed

50.

Tjensvoll K, Nordgard O, Smaaland R. Circulating tumor cells in pancreatic cancer patients: methods of detection and clinical implications. Int J Cancer. 2014;134(1):1–8. doi:10.1002/ijc.28134.CrossRefPubMed

51.

Galon J, Mlecnik B, Bindea G, Angell HK, Berger A, Lagorce C, et al. Towards the introduction of the Immunoscore in the classification of malignant tumours. J Pathol. 2014;232(2):199–209. doi:10.1002/path.4287.CrossRefPubMed

52.

Dalerba P, Sahoo D, Paik S, Guo X, Yothers G, Song N, et al. CDX2 as a prognostic biomarker in stage II and stage III colon cancer. N Engl J Med. 2016;374(3):211–22. doi:10.1056/NEJMoa1506597.CrossRefPubMed

53.

Tseng-Rogenski SS, Hamaya Y, Choi DY, Carethers JM. Interleukin 6 alters localization of hMSH3, leading to DNA mismatch repair defects in colorectal cancer cells. Gastroenterology. 2015;148(3):579–89. doi:10.1053/j.gastro.2014.11.027.CrossRefPubMed

54.

Campregher C, Schmid G, Ferk F, Knasmuller S, Khare V, Kortum B, et al. MSH3-deficiency initiates EMAST without oncogenic transformation of human colon epithelial cells. PLoS One. 2012;7(11):e50541. doi:10.1371/journal.pone.0050541.CrossRefPubMedPubMedCentral

55.

Soreide K. Receiver-operating characteristic curve analysis in diagnostic, prognostic and predictive biomarker research. J Clin Pathol. 2009;62(1):1–5. doi:10.1136/jcp.2008.061010.CrossRefPubMed

56.

Berg M, Soreide K. Genetic and epigenetic traits as biomarkers in colorectal cancer. Int J Mol Sci. 2011;12(12):9426–39. doi:10.3390/ijms12129426.CrossRefPubMedPubMedCentral

57.

Yoruker EE, Holdenrieder S, Gezer U. Blood-based biomarkers for diagnosis, prognosis and treatment of colorectal cancer. Clin Chim Acta. 2016;455:26–32. doi:10.1016/j.cca.2016.01.016.CrossRefPubMed

58.

Vandenbroucke JP. STREGA, STROBE, STARD, SQUIRE, MOOSE, PRISMA, GNOSIS, TREND, ORION, COREQ, QUOROM, REMARK… and CONSORT: for whom does the guideline toll? J Clin Epidemiol. 2009;62(6):594–6. doi:10.1016/j.jclinepi.2008.12.003.CrossRefPubMed

59.

Mallett S, Timmer A, Sauerbrei W, Altman DG. Reporting of prognostic studies of tumour markers: a review of published articles in relation to REMARK guidelines. Br J Cancer. 2010;102(1):173–80. doi:10.1038/sj.bjc.6605462.CrossRefPubMed

60.

Soreide K, Soreide AH. Using patient-reported outcome measures for improved decision-making in patients with gastrointestinal cancer—the last clinical frontier in surgical oncology? Front Oncol. 2013;3:157. doi:10.3389/fonc.2013.00157.CrossRefPubMedPubMedCentral

61.

Hagland HR, Soreide K. Cellular metabolism in colorectal carcinogenesis: influence of lifestyle, gut microbiome and metabolic pathways. Cancer Lett. 2015;356(2 Pt A):273–80. doi:10.1016/j.canlet.2014.02.026.CrossRefPubMed

62.

Mima K, Sukawa Y, Nishihara R, Qian ZR, Yamauchi M, Inamura K, et al. Fusobacterium nucleatum and T Cells in Colorectal Carcinoma. JAMA Oncol. 2015;1(5):653–61. doi:10.1001/jamaoncol.2015.1377.CrossRefPubMed

63.

Soreide K, Alderson D, Bergenfelz A, Beynon J, Connor S, Deckelbaum DL, et al. Strategies to improve clinical research in surgery through international collaboration. Lancet. 2013;382(9898):1140–51. doi:10.1016/s0140-6736(13)61455-5.CrossRefPubMed

Title: Assessment of clinically related outcomes and biomarker analysis for translational integration in colorectal cancer (ACROBATICC): study protocol for a population-based, consecutive cohort of surgically treated colorectal cancers and resected colorectal liver metastasis
Authors: Kjetil Søreide
Martin M. Watson
Dordi Lea
Oddmund Nordgård
Jon Arne Søreide
Hanne R. Hagland
ACROBATICC collaborators
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Translational Medicine / Issue 1/2016
Electronic ISSN: 1479-5876
DOI: https://doi.org/10.1186/s12967-016-0951-4

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